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By David A.Susko DDS, PC
April 08, 2022
Category: Oral Health
Tags: sensitive teeth  
UncoveringtheCauseistheFirstSteptoRelievingToothSensitivity

For one out of three Americans, a bite of ice cream or a sip of hot coffee can set off a sudden jolt of pain. Fortunately, there are ways to reduce these painful episodes of tooth sensitivity and their severity.

To understand the primary reasons that people experience tooth sensitivity, we must first consider a little tooth anatomy. Just below a tooth's outer enamel is a layer of tooth structure called dentin, composed of tiny tunnels or tubules that transmit sensations of temperature or pressure to the nerves in the central pulp. These tubules are analogous to conduits through which electrical wires pass.

Enamel on the crown, along with gum tissue and a thin material called cementum covering the roots, help muffle sensations so as to prevent an overload on the nerves. But if either of those protective areas become compromised the nerves could in turn experience the full brunt of these sensations.

As such, softened and eroded enamel from tooth decay could expose the dentin. Receding gums, commonly caused by gum disease, can also expose dentin near the roots since the remaining cementum offers little protection. In either case, nerves in the pulp may become subject to extreme sensations caused by temperature or while biting down, which then causes them to fire off pain signals to the brain.

Thus, to treat sensitive teeth we must first determine whether it's the result of tooth decay, gum disease or some other condition, and then treat any underlying disease. If it's decay-related, we'll want to repair any cavities with a filling, or perform a root canal if the infection has spread deeper into the tooth.

For receded gums, we'll first want to treat any lingering gum disease. Once we've brought the infection under control, it's possible then for the gums to heal and regenerate, eventually treating the roots with desensitizing products. In some cases, though, we may have to surgically graft new tissue to the receded area to cover the roots.

The good news is that you can lower your chances of tooth sensitivity by preventing these dental diseases. To do that, be sure you're brushing and flossing daily to remove disease-causing plaque, and visiting your dentist at least twice a year for professional cleanings and checkups.

If you would like more information on tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”

By David A.Susko DDS, PC
May 18, 2021
Category: Oral Health
Tags: sensitive teeth  
TreatingToothSensitivityDependsonItsCause

A scoop of ice cream is one of life's little pleasures.┬áBut for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”

By David A.Susko DDS, PC
November 03, 2019
Category: Oral Health
Tags: sensitive teeth  
ToothSensitivityCouldBeaSignofDeeperProblems

If you wince in pain while eating or drinking something hot or cold, you’re not alone: tooth sensitivity afflicts one in three Americans. To understand what’s possibly going on, let’s look first at tooth anatomy.

Teeth are mainly composed of three layers: an outer protective enamel that covers the upper crown, a middle layer called dentin and an inner pulp. The dentin is composed of small tubules that transmit outer temperature and pressure sensations to nerves in the pulp.

The enamel serves as a “muffler,” damping sensations to protect the nerves from overload. In the root area, the gums and a thin material called cementum covering the roots also help muffle sensation.

But sometimes teeth can lose this muffling effect and the nerves encounter the full brunt of the sensations. The most common reason is gum recession, usually caused by periodontal (gum) disease. The gums have shrunk back or “receded,” and after a short while the cementum covering will also be lost, exposing the dentin in the root area.

Another problem is enamel erosion caused by mouth acid. Chronic high acidity, often caused by bacterial growth or acidic foods and beverages, can dissolve the enamel’s mineral content, causing decay and exposure as well of the underlying dentin.

To avoid future tooth sensitivity, it pays to prevent these two dental problems. The most important thing you can do is practice daily brushing and flossing to reduce bacterial plaque and see your dentist regularly for dental cleanings and checkups.

But if you’re already experiencing symptoms, you’ll first need an accurate diagnosis of the cause. If it’s related to gum disease, immediate treatment could help stop or even reverse any gum recession. To address enamel erosion, your dentist may be able to protect and strengthen your teeth with sealants and topical fluoride.

There are also things you and your dentist can do to reduce your symptoms. One is for you to use hygiene products with fluoride, which can take the edge off of sensitivity, or potassium, which helps reduce nerve activity. Your dentist can further reduce nerve sensitivity by blocking the tubules with sealants and bonding agents.

Tooth sensitivity is an irritating problem in itself; more importantly, though, it’s often a warning of something else seriously wrong that needs attention. If you’re feeling a little sensitive in the teeth, see your dentist as soon as possible.

If you would like more information on tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity: Understanding Your Options.”

By David A.Susko DDS, PC
June 10, 2015
Category: Oral Health
Tags: sensitive teeth  
ThereareVariousWaystoTreatSensitivity-DependingonitsCause

You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.

Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.

There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.

Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.

Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.

If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.

If you would like more information on tooth sensitivity and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”

By David A.Susko DDS, PC
July 01, 2012
Category: Oral Health
UnderstandingToothSensitivity

Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.

Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.

As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”



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